Successful Recovery from COVID-19-associated Acute Respiratory Failure with Polymyxin B-immobilized Fiber Column-direct Hemoperfusion

Intern Med. 2020 Oct 1;59(19):2405-2408. doi: 10.2169/internalmedicine.5413-20. Epub 2020 Aug 29.


An 83-year-old man was hospitalized for coronavirus disease 2019 (COVID-19) after a 10-day history of a persistent fever. Chest computed tomography showed extensive non-segmental ground glass opacity. Despite the initiation of lopinavir and ritonavir, respiratory failure progressed. Two days of polymyxin B-immobilized fiber column-direct hemoperfusion (PMX-DHP) with adjunctive corticosteroid prevented his respiratory condition from worsening. For rapidly progressive COVID-19 cases, the early use of PMX-DHP may avoid the need for mechanical ventilation by suppressing local inflammation of the lung.

Keywords: COVID-19; SARS-CoV-2; acute respiratory failure; polymyxin B-immobilized fiber column-direct hemoperfusion.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / epidemiology
  • Hemoperfusion / methods*
  • Humans
  • Male
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / epidemiology
  • Polymyxin B / pharmacology*
  • Respiration, Artificial / methods
  • Respiratory Insufficiency / diagnosis
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / therapy*
  • SARS-CoV-2
  • Tomography, X-Ray Computed


  • Anti-Bacterial Agents
  • Polymyxin B